Universität zu Köln

Frankiewicz, Andrzej ORCID: 0000-0001-8826-7030, Peczynski, Christophe ORCID: 0000-0002-3829-0088, Giebel, Sebastian ORCID: 0000-0002-4827-4401, Harrington, Alenca, Socie, Gerard, Niederwieser, Dietger, Scheid, Christoph, Bornhaeuser, Martin, Kroeger, Nicolaus, Elmaagacli, Ahmet, Afanasyev, Boris, Dreger, Peter, Roessig, Claudia, Blaise, Didier, Kratz, Christian, Yakoub-Agha, Ibrahim, Kremens, Bernhard, Niemeyer, Charlotte Marie, Wulf, Gerald, Blau, Igor, Penack, Olaf, Greinix, Hildegard and Basak, Grzegorz W. (2020). Association of Country-Specific Socioeconomic Factors With Survival of Patients Who Experience Severe Classic Acute Graft-vs.-Host Disease After Allogeneic Hematopoietic Cell Transplantation. An Analysis From the Transplant Complications Working Party of the EBMT. Front. Immunol., 11. LAUSANNE: FRONTIERS MEDIA SA. ISSN 1664-3224

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Abstract

Acute graft-vs.-host disease (aGvHD) is one of the most frequent causes of transplant-related mortality (TRM) after allogeneic hematopoietic cell transplantation (alloHCT). Its treatment is complex and costly. The aim of this study was to retrospectively analyze the impact of country-specific socioeconomic factors on outcome of patients who experience severe aGvHD. Adults with hematological malignancies receiving alloHCT from either HLA-matched siblings (n= 1,328) or unrelated donors (n= 2,824) developing grade 3 or 4 aGvHD were included. In univariate analysis, the probability of TRM at 2 years was increased for countries with lower current Health Care Expenditure (HCE,p= 0.04), lower HCE as % of Gross Domestic Product per capita (p= 0.003) and lower values of the Human Development Index (p= 0.02). In a multivariate model, the risk of TRM was most strongly predicted by current HCE (HR = 0.76,p= 0.006). HCE >median was also associated with reduced risk of the overall mortality (HR 0.73,p= 0.0006) and reduced risk of treatment failure (either relapse or TRM; HR 0.77,p= 0.004). We conclude that country-specific socioeconomic factors, in particular current HCE, are strongly associated with survival of patients who experience severe aGvHD.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Frankiewicz, Andrzej UNSPECIFIED orcid.org/0000-0001-8826-7030 UNSPECIFIED Peczynski, Christophe UNSPECIFIED orcid.org/0000-0002-3829-0088 UNSPECIFIED Giebel, Sebastian UNSPECIFIED orcid.org/0000-0002-4827-4401 UNSPECIFIED Harrington, Alenca UNSPECIFIED UNSPECIFIED UNSPECIFIED Socie, Gerard UNSPECIFIED UNSPECIFIED UNSPECIFIED Niederwieser, Dietger UNSPECIFIED UNSPECIFIED UNSPECIFIED Scheid, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Bornhaeuser, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Kroeger, Nicolaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Elmaagacli, Ahmet UNSPECIFIED UNSPECIFIED UNSPECIFIED Afanasyev, Boris UNSPECIFIED UNSPECIFIED UNSPECIFIED Dreger, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Roessig, Claudia UNSPECIFIED UNSPECIFIED UNSPECIFIED Blaise, Didier UNSPECIFIED UNSPECIFIED UNSPECIFIED Kratz, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Yakoub-Agha, Ibrahim UNSPECIFIED UNSPECIFIED UNSPECIFIED Kremens, Bernhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Niemeyer, Charlotte Marie UNSPECIFIED UNSPECIFIED UNSPECIFIED Wulf, Gerald UNSPECIFIED UNSPECIFIED UNSPECIFIED Blau, Igor UNSPECIFIED UNSPECIFIED UNSPECIFIED Penack, Olaf UNSPECIFIED UNSPECIFIED UNSPECIFIED Greinix, Hildegard UNSPECIFIED UNSPECIFIED UNSPECIFIED Basak, Grzegorz W. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-325782
DOI:	10.3389/fimmu.2020.01537
Journal or Publication Title:	Front. Immunol.
Volume:	11
Date:	2020
Publisher:	FRONTIERS MEDIA SA
Place of Publication:	LAUSANNE
ISSN:	1664-3224
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE LYMPHOBLASTIC-LEUKEMIA; BONE-MARROW-TRANSPLANTATION; ACUTE GVHD; MORTALITY; SOCIETY; ADULTS Multiple languages Immunology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/32578